Ⅰ型子宫内膜癌和癌前病变组织中CRIM1表达水平及临床意义研究

The expression level and clinical significance of CRIM1 in type I endometrial carcinoma and precancerous lesions

目的 探讨Ⅰ型子宫内膜癌/子宫内膜样腺癌(EAC)及其癌前病变组织中富含半胱氨酸型运动神经元蛋白1(CRIM1)表达水平及临床意义。方法 选取2016年3月至2019年1月汉中市人民医院诊治的86例EAC患者、86例子宫内膜上皮内瘤变(EIN)患者、75例良性子宫内膜增生(BHE)患者为研究对象,收集EAC、EIN、BHE组织进行研究,并选取同期收集的53例正常增殖期子宫内膜(PE)组织进行对照研究,测定各子宫组织CRIM1 mRNA及其蛋白表达水平;分析EAC组织CRIM1蛋白表达水平与EAC患者临床病理特征、预后的关系;分析EAC患者预后的影响因素。结果 PE、BHE、EIN、EAC组织CRIM1 mRNA表达水平及其蛋白阳性表达率逐渐升高(P<0.05);EAC组织CRIM1蛋白表达水平与EAC分化程度、淋巴结转移、脉管内留栓、TNM分期相关(P<0.05);CRIM1阴性组EAC患者累积生存率高于CRIM1阳性组(P<0.05);淋巴结转移、脉管内留栓、TNM分期、CRIM1是影响EAC患者预后不良的独立危险因素(P<0.05)。结论 CRIM1表达水平与EAC临床病理特征、预后密切相关,为临床鉴别EAC与其癌前病变、评估EAC患者预后提供新视角。

Objective To investigate the expression level and clinical significance of cysteine-rich motor neuronl(CRIM1)in type I endometrial carcinoma/endometrioid adenocarcinoma(EAC)and its precancerous lesions.Methods From March 2016 to January 2019,86 patients with EAC,86 patients with endometrial intraepithelial neoplasia(EIN)and 75 patients with benign endometrial hyperplasia(BHE)were regarded as the research objects,and the EAC,EIN,BHE tissues were collected for research,another 53 cases of normal proliferative endometrium(PE)tissues collected concurrently were selected for control study.The expression levels of CRIM1 mRNA and protein in each uterine tissue were measured,the relationship between the expression level of CRIMl protein in EAC tissue and the clinicopathological characteristics and prognosis of EAC patients was analyzed,the factors influencing the prognosis of EAC patients were analyzed.Results The expression level of CRIM1 mRNA and the positive expression rate of CRIM1 protein in PE,BHE,EIN and EAC tissues gradually increased(P<0.05).The expression level of CRIM1 protein in EAC tissue was correlated with the degree of EAC differentiation,lymph node metastasis,intravascular thrombus retention,and TNM stage(P<0.05).The cumulative survival rate of EAC patients in the CRIM1-negative group was higher than that in the CRIM1-positive group(P<0.05).Lymph node metastasis,intravascular thrombus retention,TNM stage and CRIM1 were independent risk factors for poor prognosis of EAC patients(P<0.05).Conclusion The expression level of CRIMl was closely related to the clinicopathological characteristics and prognosis of EAC,which provides a new perspective for clinical identification of EAC and its precancerous lesions,and evaluation of the prognosis of EACpatients.